Medical experts say intervention is needed but disagree on implementation

A Cleveland, Ohio youth is making national headlines after he became the first case in state history (by officials' recollection) of state officials taking a child away from his parent(s)' on grounds of obesity.

But perhaps its most tragic effects have been in terms of premature disease in morbidly obese children.

The youth in this story is an eight-years-old, according to reports, and currently an honor roll student in third grade. He weighed in excess of 200 lb. (>90 kg) when he was taken from his mother. For his age and gender, the median weight (in body mass index terms) is roughly 14.8 kg/m2, according to widely available charts [source]. That means that to be a normal weight, the boy would have roughly 8 feet (2.45 m) tall.

While the state health department estimates 12 percent of third graders in Ohio to be severely obese -- 1,380 in Cuyahoga County, the boy's home region, alone -- it says that no other children have been seized.

The process began in 2010 when the child received treatment for sleep apnea, a potentially fatal obesity-related disorder. The child was prescribed a machine to help him breathe at night. Meanwhile the child's mother was strictly instructed to help him lose weight as part of a "protective supervision" program by county social workers.

The boy's mother bought him a bike and encouraged him to exercise, and it seemed to work. The boy lost some weight. But then he quickly gained it back. The mother blames a sibling and friends for giving him their extra food. She says when she became of aware of this, she tried to stop it, but by then it was too late.

While the county did not have an official policy on how to deal with extremely obese children, it decided to take away the boy after the sudden weight gain. Mary Louise Madigan, a spokeswoman for the Cuyahoga County Department of Children and Family Services comments to a local newspaper, The Plains Observer, "This child's problem was so severe that we had to take custody."

Juvenile Public Defender Sam Amata, also interviewed by the local newspaper, wasn't so sure that seizure was the best option. He states, "I think we would concede that some intervention is appropriate. But what risk became imminent? When did it become an immediate problem?"

II. Idea has Support From Some Prominent Academics

On the other Dr. David Ludwig -- a top obesity expert -- and Lindsey Murtagh, a renowned lawyer and researcher at Harvard’s School of Public Health, recently wrote in a Journal of the American Medical Association (JAMA) that extreme obesity in children in many cases was symptomatic of destructive parenting and that children needed to be taken away in extreme cases to protect them.

The study, entitled "State Intervention in Life-Threatening Childhood Obesity", states, "In severe instances of childhood obesity, removal from the home may be justifiable, from a legal standpoint, because of imminent health risks and the parents' chronic failure to address medical problems."

The study provoked controversy in a nation where one in three adults and over one in six children are clinically obese [source].

Arthur Caplan, a professor of bioethics and medical ethics at the University of Pennsylvania, suggests that the JAMA study was short-sighted because the government cannot hope to tackle America's chronic obesity epidemic via the protective services/foster care system.

He comments, "A 218-pound 8-year-old is a time bomb. But the government cannot raise these children. A third of kids are fat. We aren't going to move them all to foster care. We can't afford it, and I'm not sure there are enough foster parents to do it. "

Further complicated the bioethics issue is the fact that a great deal of research points to genetics playing a role in obesity in children and adults.

III. Should the government have a role in the obesity epidemic?

The local government's stand and other similar cases are also drawing criticism as hypocritical at a time when school lunches are considered "unhealthy" by many medical experts. While President Obama and the first lady have made healthier school lunches a top priority with their much touted "Healthy, Hunger-Free Kids Act", a 2007 U.S. Department of Agriculture audit revealed only 20 percent of schools [PDF] to be following fat guidelines.

Four out of five schools violate federal school lunch fat guidelines.
[Image Source: Growing a Green Family]

As for the boy's mother, she is understandably upset. In her interview with the local newspaper she shares that she feels villainized by county officials. She comments, "They are trying to make it seem like I am unfit, like I don't love my child. Of course I love him. Of course I want him to lose weight. It's a lifestyle change, and they are trying to make it seem like I am not embracing that. It is very hard, but I am trying."

The boy has reportedly lost a few pounds in the last month, reversing the trend of recent gains. But the foster parent he's been temporarily assigned to has reportedly been having trouble keeping up with his medical appointments. As a result the county hopes to move him to a new foster home and possible assign a dedicated personal trainer -- at local taxpayer expense -- to help the youth lose weight.

Next month the mother's lawyers and the state will plead their cases at a preliminary hearing. The final trial is set for the child's 9th birthday, before a Juvenile Court magistrate.

quote: Corn and meat are both subsidized by the government at such outrageous levels that the corn farmers are actually paid to NOT farm at times. If the subsidy went away, (which it should IMHO) you will see the cost of fast food skyrocket because corn will be more expensive, which means corn feed will be more expensive, which means the price of meat will go up.

If you took away subsidies, you'd probably see a lot of farmers selling off their land to put up housing developments and create more urban sprawl.

Also, cutting subsidies will tend to hurt poor people the most since they're less likely to be able to afford healthier, more expensive food.